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PARADIGM-HF
About the Trial
The Prospective Comparison of ARNI with ACEI to Determine Impact on Global Mortality trial randomized 8,442 heart failure patients to sacubitril valsartan or enalapril. The ARNI reduced cardiovascular death or heart failure hospitalization by 20 percent and all cause mortality by 16 percent, stopping early after 27 months. It was the first trial to beat an ACE inhibitor head to head since the class was introduced. Enhancing natriuretic peptides through neprilysin inhibition proved additive to renin angiotensin blockade. PARADIGM HF led guidelines to favor ARNI therapy over ACE inhibitors for many patients with reduced ejection fraction heart failure.
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